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CMT 1E and 2F Mutations

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CMT 1E and 2F Mutations

Neurofilament Mutations: 1E and 2F Thursday

ANN Poster Session Seattle Thursday, April 30, 2009 7:00 AM

[P07.166] Different Pathologic Features in Neurfilament Light Chain (NEFL) Pro22

Mutation in Charcot-Marie-Tooth Disease

Ji Soo Shin, Sooyeoun You, Sun Young Cho, Su Jin Hwang, Kee-Duk Park, Kyoung-Gyu

Choi, Byung-Ok Choi, Seoul, Republic of Korea

OBJECTIVE: In this present study we identified and NEFL Pro22Arg mutation in a

Korean CMT1F family and investigated the presentation and pathologic features in

comparison with previously reported Pro22 muatations.

BACKGROUND: Charcot-Marie-Tooth disease (CMT) is a form of hereditary

neuropathy. Mutations in the NEFL gene are present in CMT2E and CMT1F

neuropathies. Two NEFL gene mutations in the Pro22 locus have been reported. The

possibility that mutation in Pro22 in the head domain of the NEFL gene abolishes

the Thr-Pro phosphorylation sequence in this area by proline-directed protein

kinases has been suggested.

DESIGN/METHODS: Two patients with NEFL Pro22Arg mutations in a Korean CMT1F

family were identified. The two patients' (mother and son) clinical

manifestations of progressive neuropathy as well as electrophysiologic and

histopathologic findings were studied.

RESULTS: The proband(F/41) complained of progressive gait difficulty and lower

limb weakness. She first experienced gait difficulty at 13 years of age.

Neurological examination at 41 years revealsed distal wasting and muscle

weakness in the lower limbs and both hands, with proximal thigh muscle

invovement. Vibration and pain perception was reduced in the distal limbs, and

all muscle stretch relfexes were absent. All nerve action potentials were

undetectable. Histopathological evaluation revealed onion bulb formations but no

giant axons. The son of the patient (M/16) began to experience progressive gait

abnormalities at 3 years of age. Neurological examination revealed moderate

weakness and atrophy of distal muscles. All sensory modailites showed impairment

in the distal parts of the extremities. Stretch reflexes were absent. Nerve

conduction studies were consistent with demyelinating neuropathy.

CONCLUSIONS/RELEVANCE: The clinical and pathological characteristics defined

patients with Pro22Arg mutations reveal its association with demyelinating

neuropathy features in CMT1F. It appears that the Pro22 mutations may influence

not only the Thr-Pro phosphorylation site by proline-directed protein kinases,

but also may induce additional stuctural alteraation of the NEFL protein.

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